03D2204003 CLIA NUMBER - SPG HOSPICE, LLC

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Laboratory Demographics

CLIA Number: 03D2204003

Facility Name: SPG HOSPICE, LLC

Facility Address:
7975 N HAYDEN RD, STE B200
SCOTTSDALE, AZ
ZIP 85258
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Facility Phone Number: 480 268-2668

Facility Type: Hospice

Certificate Type: Waiver

NPI Number: 1871064071

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	03D2204003
LAB Type	Hospice
Facility Name	SPG HOSPICE, LLC
Street	7975 N HAYDEN RD, STE B200
City	SCOTTSDALE
State	AZ
ZIP	85258
Phone	480 268-2668
CertificateType	4
CertificateEffectiveDate	12/7/2022
CertificateExpirationDate	12/6/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024